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It’s an accepted, and almost expected, part of being an older guy. Those nocturnal, sleep-interrupting trips to the bathroom to empty a full bladder. If you make two or more of these on a regular basis, you meet the criteria for a condition called nocturia. The good news is that science is making progress towards helping you sleep through the night.

New research presented at the American Urological Association’s annual meeting in San Diego is being called “a significant advance” in the treatment of nocturia. It involves using a bedtime nasal spray of a synthetic hormone that cuts down overnight urine production, then wears off as you begin the next day’s activities.

Dr. Jed Kaminetsky, of NYU Langone Medical Center, tested a drug called desmopressin in people aged 50 and over. This drug is already used to treat bed-wetting in children aged 6 and older, and for some post-surgical conditions. However, the investigators are calling this application “novel” and suggesting it may offer significant benefits to adults who suffer from nocturia.

Of the 782 patients tested, 46.2 per cent reported a decrease of at least 50 per cent in nighttime bathroom breaks when given the higher of two doses of the drug. That sounds great, but 28.5 per cent of those who got an inactive spray also got this level of improvement, so there is a significant placebo effect at work here.

It’s also important to note that he research was funded by the drug’s U.S.-based manufacturer, and that the desmopressin spray, which they are calling Noctiva, is not yet approved for this use in that country. An oral form of desmopressin is approved in Canada, under the name Nocdurna, for patients with nocturia who make four or fewer trips to the bathroom per night.

It’s certainly not obvious that you should take a medicine to control nocturnal trips to the bathroom. Desmopressin may cause side-effects, the most serious being dangerously low levels of sodium in the blood. Since this is a particular risk for the elderly, a good chat with your physician is definitely in order.

There are also non-drug ways of improving this condition. Researchers at Loyola University Chicago Stritch School of Medicine found that men who exercised at least one hour per week were less likely to report nocturia than men who did not exercise. The exercisers were 13 per cent less likely to have nocturia at all, and 34 per cent less like to have severe nocturia, which is three or more bathroom trips in the night. It’s only an association, not a cause and effect connection, but certainly worth further investigation.

There are very good reasons to try to deal with nocturia. A study in presented at the European Association of Urology congress in 2013 found a “notable work productivity loss” of 24 per cent attributable to sleep disruption from nighttime bathroom trips

Philip Van Kerrebroeck, professor of urology at the University of Maastricht, was quoted in The Telegraph as saying that “nocturia is a common problem affecting around a third of adults, but its burden is underestimated and it is often dismissed as being less serious than other chronic conditions in terms of impact on quality of life and societal costs.”

While it’s pretty clear that getting up in the night to urinate impacts sleep quality, some researchers also believe that bad sleep quality can be a predictor of urinary problems as much as five years in the future.

The key study on this, by Raymond Rosen of the New England Research Institute in Watertown, MA, found that short sleep duration, defined as five hours per night or less, predicted future urinary tract symptoms in half of the men and 66 per cent of the women. In an interview he suggested, “Someone who has chronic sleep difficulties is at significantly increased risk of urologic problems, and we want to understand more about that.” Rosen suggests that sleep disturbance and urologic problems may be linked through obesity and systemic inflammation.

Of course, our bladders come along with us during the day as well, and there is a related condition called “Overactive Bladder” (OAB). Experts say that OAB may coincide with nocturia, or be completely separate. Treatment techniques range from watching your intake of fluids, especially caffeine and alcohol, to surgical procedures like percutaneous tibial nerve stimulation and an implanted device called InterStim which stimulates the third sacral nerve to inhibit the desire to pee.

Men over the age of 50 often suffer from benign prostate hyperplasia (BPH), a non-cancerous increase in the size of the prostate gland, which can contribute to nocturia symptoms. Some research has shown that sitting down to urinate can do a better job of emptying the bladder and lower the risk of complications.

Of course, there’s another option, which we might called the Thomas Edison approach. That noted American inventor supposedly slept only three to four hours per night, though he did take naps. Most experts say you should sleep a lot more than that, so it’s a good thing that we’ve invented en suite bathrooms to help us cope with that common old guy problem.

Dr. Tom Keenan is an award winning journalist, public speaker, professor in the Faculty of Environmental Design at the University of Calgary, and author of the best-selling book, Technocreep, (www.technocreep.com).

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